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Medicina (Kaunas) 2021 Apr 1;57(4). Epub 2021 Apr 1.

Clinic of Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care, Institute for Pneumology at the University Witten/Herdecke, 42699 Solingen, Germany.

Obstructive sleep apnea (OSA) syndrome is a multi-factorial disorder. Recently identified pathophysiological contributing factors include airway collapsibility, poor pharyngeal muscle responsiveness, a low arousal threshold, and a high loop gain. Understanding the pathophysiology is of pivotal importance to select the most effective treatment option. Read More

Eur Arch Otorhinolaryngol 2021 Apr 22. Epub 2021 Apr 22.

Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.

Purpose: To assess predictors of success and failure of an updated lateral pharyngoplasty as an independent procedure in treating obstructive sleep apnea with CPAP failures.

Methods: Forty-six patients with known OSAS who were resistant to CPAP or failures were included. BMI, Stop-Bang score, and sleep study data were recorded before and after the updated Cahali pharyngoplasty procedure. Read More

Sleep Med 2021 Mar 29;79:101-106. Epub 2020 Dec 29.

Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Objective: The effects of vagus nerve stimulation (VNS) on sleep disordered breathing (SDB) have been reported in limited case series. Detailed studies, particularly in the pediatric population, have not been performed. The primary purpose of this study is to describe clinical characteristics, polysomnographic findings, and management of children treated with VNS. Read More

Sleep Biol Rhythms 2020 Nov 7:1-2. Epub 2020 Nov 7.

Professor Emeritus, University of Sydney, Sydney, Australia.

Cochrane Database Syst Rev 2020 11 3;11:CD013449. Epub 2020 Nov 3.

Bilbao, Spain.

Background: Obstructive sleep apnoea (OSA) is a syndrome characterised by episodes of apnoea (complete cessation of breathing) or hypopnoea (insufficient breathing) during sleep. Classical symptoms of the disease - such as snoring, unsatisfactory rest and daytime sleepiness - are experienced mainly by men; women report more unspecific symptoms such as low energy or fatigue, tiredness, initial insomnia and morning headaches. OSA is associated with an increased risk of occupational injuries, metabolic diseases, cardiovascular diseases, mortality, and being involved in traffic accidents. Read More

Sleep Breath 2020 Oct 1. Epub 2020 Oct 1.

Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China.

Purpose: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with alterations in glucose metabolism. The Berlin questionnaire (BQ) is effective in identifying subjects with high risk of OSAHS. However, its validity in patients with glucose metabolic dysfunction remains unclear. Read More

Auris Nasus Larynx 2021 Jun 8;48(3):339-346. Epub 2020 Sep 8.

Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery, Rush University Medical Center, Chicago, IL, USA; Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.

Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies such as oral appliance, sleep hygiene and sleep positioning may help some of these patients, there are many who fail all conservative treatments. Read More

Cureus 2020 Aug 17;12(8):e9796. Epub 2020 Aug 17.

Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.

Obstructive sleep apnea (OSA) is a common condition, and if not treated can be a significant risk factor for multiple comorbidities like hypertension (HTN), coronary artery disease (CAD), and congestive heart failure (CHF). The underlying pathophysiology involves coagulation and inflammatory pathways, including an overactive sympathetic nervous system. This ultimately causes hemodynamic changes and subclinical myocardial injuries. Read More

Heart Lung 2020 Nov - Dec;49(6):940-948. Epub 2020 Aug 13.

Department of Chest Medicine and Sleep Center, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.

Background: Inspiratory muscle training (IMT) and oropharyngeal exercises (OE) have different advantages and disadvantages and a comparison of these modalities has been recommended. The aim of this study was to compare the effects of IMT and OE on important outcomes for patients with OSAS.

Methods: This was a randomized controlled clinical trial. Read More

JMIR Res Protoc 2020 Aug 14;9(8):e14786. Epub 2020 Aug 14.

Pulmonary Division-Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil.

Background: Mounier-Kuhn syndrome or congenital tracheobronchomegaly is a rare disease characterized by dilation of the trachea and the main bronchi within the thoracic cavity. The predominant signs and symptoms of the disease include coughing, purulent and abundant expectoration, dyspnea, snoring, wheezing, and recurrent respiratory infection. Symptoms of the disease in some patients are believed to be pathological manifestations arising due to resident tracheobronchomalacia. Read More

Cureus 2020 May 22;12(5):e8241. Epub 2020 May 22.

Psychiatry, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.

Obstructive sleep apnea (OSA) is defined as episodes of hypopnea or apnea, which leads to a partial or complete block of airways. Hypertension, on the other hand, is defined as an increase in systemic arterial blood pressure to a certain threshold. OSA and hypertension share many common factors in pathophysiology, such as gender, obesity, unhealthy lifestyle, impaired quality of sleep, renin-angiotensin system, and increased fluid distribution. Read More

EPMA J 2020 Jun 13;11(2):251-260. Epub 2020 May 13.

Institute of Cognitive Science, Woosuk University, Wanju, South Korea.

Background: Sleep disorders are very common in migrants and refugees, often as a comorbid disorder to different somatic or psychiatric diagnoses and psychological disturbances such as metabolic syndrome, post-traumatic stress disorder, depression, and anxiety disorders.

Objectives: To review published prevalence rates as well as possible predictors for sleep disturbances in these vulnerable groups, including pre-migration stress, acculturation, and trauma before, during, and after migration, integration, and lifestyle in the host country with implications for predictive, preventive, and personalized medical approach (3PM).

Data Sources: Electronic databases PubMed, PsycInfo, and Web of Knowledge were searched using (combined) search terms "migrant," "asylum seeker," "refugee," "sleep disturbances," "sleep disorder," "insomnia," and "sleep wake disorder. Read More

Am J Otolaryngol 2020 Jul - Aug;41(4):102500. Epub 2020 Apr 21.

Chest Diseases, Faculty of Medicine-Kafrelsheikh University, Egypt.

Background: Obstructive sleep apnea syndrome (OSAS) is caused by a complete or partial obstruction of the upper airway. A new Cahali lateral pharyngoplasty as a stand-alone procedure for the treatment of OSA patients, whatever the level and pattern of airway obstruction in patients with CPAP failure or non-compliant patients, is it?

Patients And Methods: 40 patients with known OSAS non-compliant with CPAP or CPAP failures included. BMI, Stop-Bang score, and sleep study parameters were reported before and after the new Cahali pharyngoplasty operation. Read More

Cranio 2020 Apr 18:1-6. Epub 2020 Apr 18.

Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

: Obstructive sleep apnea (OSA) is an increasing health problem worldwide. The aim was to evaluate long-term mandibular advancement device (MAD) therapy outcomes in community dental care among OSA patients in Finland.: In all, 142 (77. Read More

Am J Otolaryngol 2020 Nov - Dec;41(6):102460. Epub 2020 Mar 16.

Bezmialem Vakif University, Faculty of Medicine, Department of Otorhinolaryngology, Fatih, Istanbul, Turkey.

Objective: The objective of this study is to create a new choice of treatment with nasopharyngeal stent in isolated retro palatal obstruction and snoring for the treatment of obstructive sleep apnea syndrome (OSAS).

Material And Method: The study included five patients with mild OSAS and snoring. Nasopharyngeal stents were applied in these patients with drug-induced sedation endoscopy. Read More

Otolaryngol Clin North Am 2020 Jun 17;53(3):385-395. Epub 2020 Mar 17.

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, 2233 Post Street, Box 1225, San Francisco, CA 94115, USA. Electronic address:

Assessment of the nose is critical in evaluating obstructive sleep apnea (OSA) because the nose plays an important role in the physiology of sleep by regulating nasal airway resistance and stimulating ventilation. Nasal obstruction is common in sleep apnea, contributes to OSA, and interferes with tolerance of OSA treatment with continuous positive airway pressure (CPAP) or oral appliances. Medical treatment of nasal obstruction and rhinitis with nasal corticosteroid sprays is associated with improved OSA severity and sleep symptoms. Read More

Int J Cardiol Heart Vasc 2020 Feb 19;26:100447. Epub 2019 Dec 19.

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

Background: Recent studies have suggested an association between sleep apnea (SA) and atrial fibrillation (AF). We aimed to study the prevalence, characteristics, risk factors and type of sleep apnea (SA) in ablation candidates with paroxysmal AF.

Methods/results: We prospectively studied 579 patients with paroxysmal AF, including 157 women (27. Read More

Praxis (Bern 1994) 2020 ;109(3):207-213

Klinik für Pneumologie, Universitätsspital Zürich, Zürich.

CME: Obstructive Sleep Apnea: A Common Disease Obstructive sleep apnea is a common sleep related breathing disorder with a collapse of the upper respiratory tract, leading to repetitive oxygen desaturations and 'micro arousals'. If the physiological sleep architecture is impaired, patients are at risk for an increased daytime sleepiness and an increased blood pressure. Main risk factors are central obesity, age, male sex, (and snoring). Read More

Laryngoscope 2020 12 28;130(12):2917-2921. Epub 2020 Feb 28.

Division of Sleep Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A.

Objectives/hypothesis: Hypoglossal nerve stimulation (HGNS) effectively treats obstructive sleep apnea in select patients. Drug-induced sleep endoscopy (DISE) is required for HGNS candidacy. Data suggest that mandibular advancement (MA) devices and HGNS share similar target populations. Read More

Laryngoscope 2020 09 11;130(9):2292-2298. Epub 2020 Feb 11.

Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Objective: To assess the risk of Alzheimer's disease (AD) in patients with obstructive sleep apnea (OSA) with or without treatment based on real-world evidence.

Study Design: Retrospective cohort study.

Methods: Patients newly diagnosed with OSA during 1997-2012 were identified using the National Health Insurance Research Database of Taiwan. Read More

Acta Otorhinolaryngol Ital 2019 Dec;39(6):404-408

Unit of Otorhinolaryngology, Head and Neck Surgery, Humanitas San Pio X, Milan, Italy.

Cranio 2020 Jan 7:1-10. Epub 2020 Jan 7.

Department of Pulmonology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands.

: To investigate the effectiveness and adverse events of mandibular advancement device (MAD) in patients with obstructive sleep apnea (OSA) and to identify predictive clinical parameters for therapy success.: A retrospective analysis of 318 patients indicated for MAD therapy, observed in a large teaching hospital in the Netherlands.: Ninety-seven patients (65. Read More

Sleep Breath 2020 Sep 12;24(3):1043-1050. Epub 2019 Nov 12.

Sleep Lab, Hospital de Clínicas, Ciudad Autónoma de Buenos Aires, Argentina.

Objective: To evaluate the performance of clinical criteria (CC) for diagnosis and initiation of empirical treatment with continuous positive airway pressure (CPAP) in patients with suspected obstructive sleep apnea (OSA) compared with the treatment decision based on sleep studies (polysomnography or respiratory polygraphy), guidelines, and experience of participating physicians.

Methods: This was a simulated intention-to-treat study in a retrospective (G1) and prospective (G2) cohort. Four observers (two per group) called CC1 and CC2 reviewed the sleep questionnaires and indicated CPAP if the patients presented snoring, frequent apneas (≥ 3-4/week), body mass index (BMI) > 25 kg/m, sleepiness (Epworth > 11), or tiredness (at least 3-4 times per week) and some comorbidity (hypertension, coronary/cerebrovascular event, diabetes). Read More

Ethiop J Health Sci 2019 Sep;29(5):585-590

School of Medicine, Georgetown University, Washington, District of Columbia, United States.

Background: Obstructive Sleep Apnea (OSA) is prevalent throughout the world. However, there are currently limited data concerning the prevalence of OSA in populations that originate from developing countries; the prevalence of OSA is expected to rise in these countries. OSA is poorly characterized amongst Ethiopians, and our study is the first to describe clinical characteristics of OSA among Ethiopians. Read More

Trials 2019 Oct 29;20(1):615. Epub 2019 Oct 29.

Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium.

Background: The amount of mandibular protrusion is a key factor in optimizing the efficacy of mandibular advancement device (MAD) therapy in an individual patient diagnosed with obstructive sleep apnea. This process is called titration and is generally based on resolution of subjective symptoms like snoring and/or daytime sleepiness as a function of protrusion. An objective approach uses a remotely controlled mandibular positioner (RCMP) during a full-night polysomnography (PSG), in analogy with continuous positive airway pressure (CPAP) titration. Read More

Cranio 2019 Oct 5:1-12. Epub 2019 Oct 5.

Department of Dental Propedeutics and Esthetics, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca , Cluj-Napoca , Romania.

: Oral appliance therapy is a non-invasive treatment that offers a wide variety of oral devices for the treatment of obstructive sleep apnea (OSA). The present review focuses on the effectiveness of mandibular advancement devices for the treatment of OSA. : A systematic review based on the PRISMA checklist was carried out. Read More

Sleep 2019 10;42(10)

Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Adelaide, Australia.

Study Objectives: Poor adherence to continuous positive airway pressure (CPAP) commonly affects therapeutic response in obstructive sleep apnea (OSA). We aimed to determine predictors of adherence to CPAP among participants of the Sleep Apnea and cardioVascular Endpoints (SAVE) trial.

Methods: SAVE was an international, randomized, open trial of CPAP plus usual care versus usual care (UC) alone in participants (45-75 years) with co-occurring moderate-to-severe OSA (≥12 episodes/h of ≥4% oxygen desaturation) and established cardiovascular (CV) disease. Read More

Br Dent J 2019 Sep;227(6):470-473

Consultant Orthodontist, Department of Orthodontics, Victoria Hospital, Kirkcaldy, UK.

Introduction Mandibular replacement appliances (MRAs) can be used in the treatment of snoring, mild to moderate obstructive sleep apnoea and as a second-line treatment where continuous positive airway pressure (CPAP) fails. There is currently a paucity of evidence as to how long these appliances last.Aims Assess the replacement rate for MRAs using this as a proxy for lifespan; estimate the period prevalence of temporomandibular joint disorder (TMJD) and bruxism in the study population. Read More

J Family Med Prim Care 2019 Aug 28;8(8):2728-2731. Epub 2019 Aug 28.

Department of Prosthodontics Crown and Bridge and Implantology, C.K.S. Theja Institute of Dental Sciences and Research, Chadalawada Nagar, Renigunta Road, Renigunta, Tirupati, Andhra Pradesh, India.

Snoring is common disorder in India, which is caused due to obstructive sleep apnea. Nasal continuous positive airway pressure (CPAP) is an effective treatment for this condition. Prefabricated nasal masks lack intimate adaptation and cause air leakage producing discomfort for patient and decrease the compliance for treatment. Read More

Laryngorhinootologie 2019 Sep 9;98(9):638-650. Epub 2019 Sep 9.

The prevalence of mild obstructive sleep apnea (OSA) in adults is 20 %, of moderate to severe OSA about 6-7 %. The current gold standard for the treatment of moderate to severe OSA is the continuous positive airway pressure (CPAP) therapy. It is the most effective treatment modality, if there is good compliance and therapy adherence. Read More